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Если галочки не стоят — только metapractice

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metanymous в посте Metapractice (оригинал в ЖЖ)


Of course, we could describe the therapeutic process John went through in neurological terms by calling it memory reconsolidation. He did, in fact, recode his past traumatic memories. But that wouldn’t tell us how to do anything we don’t already know how to do, and it wouldn’t help us get the same results with someone else suffering from PTSD. Even if we assume that most of our current neuroscience information is valid, as the proponents of memory reconsolidation do, it remains to be seen how any part of this knowledge could have improved on the changes that John experienced from a simple visualization process.
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metanymous в посте Metapractice (оригинал в ЖЖ)


John didn’t have to continue to rehearse the process or consciously use this skill with each of his awful memories one at a time. Research in cognitive linguistics shows that we typically put all similar memories into a single category—which can include subcategories and may overlap with other categories—and that we use a prototype experience to represent the entire category. Typically, in the case of repeated trauma, the worst example of it—which is often the first example because of the shock and surprise—will become the prototype for that category. If you change this prototype, all the other examples in the category will change, and this happens instantly.
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metanymous в посте Metapractice (оригинал в ЖЖ)


Seeing things objectively is a mental skill that everyone has, but few people realize it, and fewer still can use it selectively to neutralize their responses to unpleasant events. This skill gives people the ability to remember horrible events while leaving behind the terrible feelings, retaining for their own protection whatever needs to be learned from these experiences. This process becomes a life skill that clients can apply to many other difficult experiences beyond the scope of their presenting problems.
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metanymous в посте Metapractice (оригинал в ЖЖ)


Putting neurobiological analysis aside, the structure of John’s problem was simple: he’d been through horrible experiences, and when he remembered one, it was as if it were happening to him again in the present. The solution to his problem was just as simple: teaching him how to view the horrible memory at a distance, as if it were happening to someone else in a movie. This technique is often called “being objective.” Seeing himself experiencing horrible feelings out there implies that he doesn’t have to experience them here in his body.
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metanymous в посте Metapractice (оригинал в ЖЖ)


John reported that he was now sleeping well and waking up rested, and that his nightmares were a thing of the past. He added that the first time he’d watched the movie The Boys from Company C, about the Vietnam War, “It was hell for two weeks.” When he watched it again after the session, he didn’t have any problematic responses. Also, he’d become good friends with two Asian people, and had gone to a Japanese restaurant, where he’d ordered the meal in Japanese, a language he hadn’t used in a dozen years. Deeply moved, he said how grateful he was for his renewed ability to connect with Asians as people, rather than as reminders of past horrors.
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metanymous в посте Metapractice (оригинал в ЖЖ)


In a videotaped follow-up interview about a month after the session, John said that the day after the session, he went to a weekend seminar with his wife. At the end of the first day, she said to him, “What’s happened with you? You’re different. You used to jump when people came up behind you, and you’re not doing that anymore.” Thinking back, he realized that she was right, but he hadn’t noticed it. This response is typical for people who make a thorough and congruent change: the new normal is so unconscious that they often don’t notice the difference unless someone else points it out.
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metanymous в посте Metapractice (оригинал в ЖЖ)


This method is a simple process instruction that can be done without any knowledge of the content of the traumatic event, making it straightforward and respectful of a client’s privacy. The session with John took about 40 minutes, most of which was spent convincing him to try the process, since he’d previously been through hundreds of hours of therapies that had required him to relive the horror fully, but hadn’t changed his response.
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metanymous в посте Metapractice (оригинал в ЖЖ)


In brief, Connirae asked John to imagine being in a movie theater sitting way back from the screen and then to float out of his body and up to the projection booth, from which he could see both the movie screen and himself sitting in the theater below. From this position, she told him to watch a black-and-white movie of himself that spanned the incident in that marketplace in Pleiku but ended later, giving him a longer perspective. Finally, she instructed him to leave the projection booth, step inside the movie at the end, and run it backward in color very quickly, in about a second and a half. This step reverses the cause-and-effect stimulus–response sequence, so that the feeling responses come before the triggers for them, changing their meaning.
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metanymous в посте Metapractice (оригинал в ЖЖ)


John had struggled with these symptoms for years and had tried every kind of therapy he could find, yet after a single session with my wife, Connirae, he experienced immediate relief from his symptoms after going through a simple process that taught him how to view his worst memory as if he were a distant bystander. A one-trial learning, not a treatment based on some complex neurological insight, transformed his life.
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metanymous в посте Metapractice (оригинал в ЖЖ)


After returning home, John had all the symptoms of post-traumatic stress disorder (PTSD). He regularly woke from nightmares of being back in Vietnam, thrashing and screaming. Sometimes his wife had to sleep in another room to avoid being hit. After this kind of night, John would be 10 times as tired the next day as he’d been when he’d gone to bed. Once, at an outdoor flea market, he’d had a waking nightmare that started when he heard people speaking Vietnamese. When he looked up, he saw a large Vietnamese family walking toward him. This sight, he said, “clicked me right back to the most violent incident that occurred to me in Vietnam. Then, suddenly, everyone around me was Vietnamese.” He’d panicked and run back to his car. Since returning from Vietnam, he’d found himself increasingly avoiding all people and things Asian. And he had an exaggerated startle response: if anyone unexpectedly touched or spoke to him from behind, he’d jump and have to restrain himself from hitting them.

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